| NPI | 1548814189 |
|---|---|
| Other Name | DR. TIESHA NELSON |
| Entity Type | Organization |
| Authorized Contact | TIESHA S NELSON CEO 954-294-8139 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 101YM0800X Counselor, Mental Health | |
| 103T00000X Psychologist | |
| 171M00000X Case Manager/Care Coordinator | |
| 2084P0800X Psychiatry & Neurology, Psychiatry | |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| Enumeration Date | 2019-07-31 |
| Last Update Date | 2020-06-15 |